Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Omar Klobocista, MD

Individual provider Family Medicine Physician · NPI 1093040115

Dr. Omar Klobocista, MD is a Family Practice in Staten Island, New York. Qualified in 2004, 22 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
22
Licensed in
NJ, NY
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

220 Victory Blvd
Staten Island, NY 10301-2919
Phone: (856) 524-2531
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 255828 (NY)
Family Medicine Physician Taxonomy 207Q00000X · Licence 25MA08645900 (NJ)

Record details

NPI number1093040115
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 7, 2009
Last updated in NPPESFebruary 18, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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